Inspection on 22/09/05 for Walton House

This inspection was carried out on 22nd September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Walton House 24/02/09

Walton House 02/03/07

Walton House 31/01/06

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Walton House Hall Road Wallington Surrey SM6 0RT Lead Inspector Mohammad Peerbux Unannounced Inspection 22 September 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Walton House Address Hall Road, Wallington, Surrey, SM6 0RT Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8647 8836 020 8669 9382 Loving Care Ltd Care Home 6 Category(ies) of Learning Disability (6) registration, with number of places Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection N/A Brief Description of the Service: Walton House is owned, managed and staffed by loving Care Ltd. It is a six bedded home registered with the Commission for Social Care Inspection to provide residential care for adults with learning disabilities with low through to high support needs. There are currently five service users’ residing at the home. Sufficient numbers of bathroom and toilet facilities are available for service users.The home is a large detached property situated in a residential street close to the center of Wallington and well placed for accessing local shops and public transport links. The property is built over three-stories and comprises of single occupancy bedrooms, all with WC’s and washing facilities. There are two bathrooms, & one shower room. Also there is one lounge, one conservatory, a dining room, kitchen with a dining table, laundry, office and a room known as ‘The retreat.’ Service users can use this room as another sitting room during the evenings and day to undertake activities if they wish. The homes gardens are well maintained and the home is in the process of constructing a new development to the front of the home. Service users are helping choose how the front should look and been having an active involvement in the selection of ornaments and design.The service provided is in line with its aims and objectives as set out in its statement of purpose. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first inspection for the year 2005/06. It was an unannounced inspection and took place over four hours. Some times were spent looking at the policies and procedures, talking to the acting manager and to one of the service users. A tour of the building was also carried out. They are all thanked for their time and all of those who provided feedback for their support in the inspection process. Overall the inspection confirmed that the home provides a good level of care for the service users who live there. What the service does well: Comprehensive information about the home and the services offered (included in the Statement of Purpose and Service User Guide) is available, and potential service users (and their relatives) are encouraged to visit the home, enabling an informed choice regarding the suitability of the home to be made. A sample of service user files was examined. The home was evidenced to have appropriate assessments and care plans in place. Service users’ care and support needs had been properly assessed, and the range of health, care and social needs presented were evidenced as being met. The home encourages service users to make decisions about all aspects of their lives; this includes what to eat, where to go on holiday, for days out, and what clothes to buy. Service user spoken to felt that the staff have built a good relationship with him. The home has a settled staff group and has the numbers and skill mix of staff sufficient to meet service users’ needs. Service users were observed to be treated with respect by staff and to have their privacy and dignity respected. Comments from service users were generally positive, with indication that staff are kind and helpful in meeting their care needs. The rights and best interests of service users are generally being protected by the home’s policies and procedure; and by accurate, up-to-date and wellmaintained record-keeping. There are good opportunities for the service users to maintain contact with their families and friends. Care plans set out well the individual needs of the service users and how staff members should meet these needs. Healthcare Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 6 needs are well monitored and the home liaises with a range of health care professionals in meeting individual needs. The home is pleasantly designed and furnished, providing communal living, recreational and dining space that meets individual and collective needs. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 and 5 The Statement of Purpose, and Service User Guides’ provide prospective service users with details of the services the home offers. This enable them to make an informed decision about admission to the home .All prospective service users have their needs assessed prior to admission to ensure that the home and staff are aware of their assessed needs. Prospective service users have the information they need to make informed choices about the home and are given the opportunity to visit the home and meet the other service users and staff before prior to deciding whether to move into the home. The home issues contracts that contain all the information required under the Care Home Regulations and individual details on how the home will meet the service users needs. EVIDENCE: The home has a comprehensive Statement of Purpose, and Service Users’ Guide. Both are extremely well presented and cover all the information required by the Care Homes Regulations (2001), including the aims and objectives of the home and the facilities and services provided. This Statement of Purpose was last updated on the 10/07/05. The service users’ guide is Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 9 written in plain English and is also available in pictorial format. It is recommended on the Statement of Purpose and Service Users’ Guide. Service users are only admitted to the home after a full assessment of their needs has been carried out by the home and the Placing Authority for individuals referred through Care Management, involving the prospective service user/recognised representative. It was noted that the home also carries out a very comprehensive needs assessment. It was clear from care plans sampled at random that service user’s needs are being met. Records revealed that service users are in regular contact with other health and social care professionals who regularly visit the home to check that assessed needs are being met. The registered provider confirmed that all prospective service users are encouraged to visit the home as often as practical, to encourage a familiarisation process with the premises, its location and the other service users and staff. Strategies are in place to enable the service user to “try out the home.” They would be encouraged by staff to meet the other service users through having a meal or two in the home and also overnight stay. Service users or their recognised representatives are provided with a costed contract/statement of terms and conditions of occupancy which are agreed between each prospective service user and/or representative and the home. The home also has a Client agreement that is illustrated in the service user’s plan and also in writing explaining what the home charges extra for. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 and 10 Care plans are comprehensive and include detailed information about service users’ needs, personal goals, wishes and risk assessments. Service users are involved in decision making about their lives, they participate and can take some risks so that they live as normal a life as possible. Service users are offered opportunities to participate in the day-to-day running of the home. The home has a confidentiality policy in place, which ensure information is handled in the best interests of the service users. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 11 EVIDENCE: Three service user care plans were sampled, it was noted that they were all up to date and well-maintained. Overall, the plans demonstrated a thorough needs assessment, which clearly set out how current and anticipated needs would be met. The plans checked established individualised procedures for service users likely to challenge the service, focusing on positive management strategies. The home reviews the care plan of the service user every six months. Documentary evidence was available to show that the annual review included the care manager and/or other professionals from the placing authority. The rights of service users to make decisions about their own lives is central to the ethos of the home, support and guidance is given in all areas to ensure that service users are making decisions which are in their best interests. From discussion with service user and staff no evidence of restrictions on service users were found. Service users are able to arrange their own activities and social events and prepare this to happen. One service user has made the decision to write a monthly newsletter that he sends out to various people to keep everyone updated with what is going on at Walton House. Risk assessments for service users were examined; they are integrated into the care plan. Potential risks are identified covering all aspects of their daily living both inside and outside the home. The home was able to demonstrate that this standard was met as individualised care plans were in place for each service user that referred to action required to minimise identified risks and hazards. The home also has a comprehensive missing person’s policy, which gives staff clear guidance if a service user was to go missing. The home has a confidentiality policy in respect of personal information held in relation to service users. General service user’s documentations (i.e. service user plan, medical appointments and reviews) are kept locked in the office. Staff respect information given by service users in confidence and sign a ‘Code of Confidentiality agreement’ when they start employment at Walton House. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15 and 16 Service users are encouraged to explore opportunities to enhance their quality of life as well as maintain and participate with friends and the local community, with the aim of maximum integration. The daily routines and house rules promote service users’ rights, and ensure equality and that all rights are enjoyed by service users. EVIDENCE: The inspection findings indicated staff work very closely with the service users to develop independent living skills at the home. It was observed staff assisting users with making decisions about tasks, activities inside and out of the home. Evidence recorded in individual care plans also indicated staff offer support, advice and other input that help to enhance and develop independent living skills. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 13 All service users have very active day activities that are arranged outside of the home on a daily basis. One service user attends a work placement 5 days a week in Wimbledon. Another service user attends Hallmead Day Centre 4 days per week and the other day attends college. One service user attends St Ebbas for carpentry 3 days per week and also attends Hallmead twice a week. One service user who is more able goes to work and also attends college. Another service user attends college twice a week and Hallmead twice per week. The home offers a wide range of opportunities for service users to participate in all number of educational, occupational, and valued social activities including gardening, arts and crafts, etc. Service users are able to access a wide range of community activities and resources including swimming, mencap, bingo, horse riding, social evening, local pubs, discos and restaurant. Activity plans are individualised. The service users are clearly all able to express their social / leisure needs and interests. Staff support service users in pursuing these activities if and when necessary / requested. Service users take part in a range of local leisure activities. Service users are actively encouraged to maintain links with their families and friends. The home has an ‘open’ visitor’s policy and simply recommends that visitor’s telephone to say they are coming to ensure there loved one will be available. Service user, who was at home at the time of this inspection, appeared to enjoy a high level of independence at the home. Routines can be very flexible and are well observed to take into account all the service users individual needs. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 20 Service users’ personal, physical and emotional health needs are being appropriately met and reviewed. This ensures that the service users’ physical and emotional health is well maintained and therefore the quality of life experienced is also maximised. Generally service users’ medication is well managed to ensure maximised good health. EVIDENCE: The findings indicated that service users are able to exercise some level of independence in their personal care needs with appropriate support from staff where needed. The overall impression gained from observing how service users live at the home, indicated a good culture of semi-independent living, with most users have reasonable control over their lives and support from staff where needed. In general, medication records, including medicines received, administered and returned were all being appropriately maintained. Medication profiles in respect of each service user were also available. The home uses a blister pack system for medication. None of the service users self medicate. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The home has appropriate complaints procedure in place. The home has suitable vulnerable adult protection and abuse prevention measures in place to ensure the service users are so far as reasonable practicable protected from abuse, neglect and/or harm. EVIDENCE: The current complaints procedure is a good and gives clear step-by-step guide of how to make a complaint. The procedure is also available in symbol format. The home has copies of London Borough of Croydon and London Borough of Sutton adult protection procedures. Staff have training in adult abuse with the London Borough of Sutton and in house adult abuse training also by Mulberry House which is accredited. There have not been any adult protection concerns raised since the home has been registered. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,26,28,29 and 30 The overall impression when visiting this home is that it is homely, comfortable clean and hygienic and the staff successfully promote an environment which contributes to the service users health and emotional well-being. EVIDENCE: The home is suitable for its stated purpose. It is accessible, meet service users’ individual and collective needs in a comfortable and homely way. Service users’ bedroom are personalised to reflect their individual needs, and personalities. Overall the home was decorated to a good standard throughout and appeared to be very comfortable, bright and warm. The inspection findings indicated the home provides adequate living and bedroom spaces for each service user. Some of the bedrooms were checked. They were decorated to a good standard. The rooms contained a variety of personal furniture and fittings that reflected the individual’s personality. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 17 The ground floor of the home is very spacious. The accommodation includes a spacious lounge, which was large enough for all the service users to sit together if they wished. The dining room area was again domestic in nature and contained suitable tables and chairs. The garden was well maintained. The home has a no smoking policy but service users can smoke outside in designated areas. The service users at Walton house are all mobile and do not require any adaptations to the home at present. The home is kept very clean and hygienic and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,34 and 36 The staff team at the home have a range of skills and ability, which appear to meet the needs of the service users. The home’s recruitment procedures protect the service users through vigorous staff vetting. Care staff are receiving supervision on a regular basis, which contributes to the standards of care being provided to service users. EVIDENCE: The registered provider stated that all staff have a job description in place. The job descriptions contain the main purpose, tasks, including household and administrative tasks staff are expected to perform and be responsible for. All staff have been provided with copies of the General Social Care Council Code of conduct and signed to say they have one. Most staff have had the basic training and new staff have a three-day induction. Staff have training in Autism, Food hygiene, First Aid, First Aid at Work, Adult protection, Moving and Handling, Risk Assessments, Health & Safety, Introduction to Epilepsy, Care of Medicines and Fire Safety. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 19 As part of the inspection process staff files were sampled at random and found to contain photographs, application forms, references, criminal record checks, application forms and copies of identification. The registered provider advised that all the homes care staff receive at least six supervisions a year covering good care practices and career development. From staff files sampled at random there were evidence that staff are being supervised on a regular basis. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40 and 42 The home is managed by an experienced and well-qualified acting manager who ensures a quality service. There is an excellent quality monitoring system. This ensures the home is run in a way that is in the best interests of the service users Generally the health, safety and welfare of the service users and staff were being promoted and protected EVIDENCE: Throughout the course of the inspection the registered provider demonstrated a good competent management skills and appears to have created a skilled, positive and enthusiastic workforce. She has experience of working with this client group and displayed an insight into the relevant issues. It was obvious that service users choices were catered for and respected in the home and that the home was run to the needs of the service user. Service user Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 21 spoken to on the day of the inspection seemed happy, confident and comfortable in his surroundings. The registered provider informed that there are regular service users’ meeting where the service users have an opportunity to discuss about the service they are being provided. There is also a quality assurance audit that is carried out to measure the home success in achieving its aims and objectives. “Regulation 26” is also carried out on a regular basis by the Registered Provider. The home appears to be well organised and record keeping very competently managed. Administration in this home is to a good standard. All statutory record keeping checked were satisfactory; this included medication, food, statement of purpose, service user case files, accidents, incidents, complaints, fire records and so forth. The home ensures so far as is reasonably practicable the health, safety and welfare of service users and staff. Fire alarms are tested weekly and fire drills are undertaken on a monthly basis. All staff have completed fire training .It was noted that COSHH products were all securely stored in a locked cupboard in the laundry room. Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 3 x 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Walton House Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x 3 x G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 23 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 1 Good Practice Recommendations Walton House G53 S60854 WaltonHouse V238016 220905 stage4.doc Version 1.40 Page 24 Commission for Social Care Inspection 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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